Using the think aloud protocol in health professions education: an interview method for exploring thought processes: AMEE Guide No. 151

Abstract

The think aloud protocol (TAP) has two components, the think aloud interview, a technique for verbal data collection, and protocol analysis, a technique for predicting and analyzing verbal data. TAP is a useful method for those attempting to observe, explore, and understand individuals’ thoughts, which remain among the most difficult research areas in health professions education. Notably, the long, complex history and heterogeneous implementation of variations of TAP can make it difficult to understand and implement rigorously. In this Guide, we define the TAP and related concepts, describe the origins, outline applications, offer a detailed roadmap for rigorous implementation as a technique for data collection and/or data analysis, and suggest opportunities for adaptation of the traditional TAP. We aim to arm researchers with the tools to implement a rigorous think aloud interview, while explaining its origins to empower them to adapt the traditional TAP intentionally and justifiably to modern health professions education research.

Keywords:

• Methods
• medical education research
• decision-making

Acknowledgements

A special thank you to Dr. Lara Varpio, who assisted with the literature review, outline, and focus of this manuscript. And thank you to Dr. John (Eddie) Atwood for serving as a participant in the think aloud interview included as an example in this Guide.

Disclosure statement

The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense or the U.S. Government.

Additional information

Notes on contributors

W. Rainey Johnson

W. Rainey Johnson, MD, MHPE, MEd, is an assistant professor in the departments of Military and Emergency Medicine and Medicine at the Uniformed Services University of Health Sciences in Bethesda, MD.

Anthony R. Artino

Anthony R. Artino Jr., PhD, is a professor and associate dean for evaluation and educational research at the George Washington University School of Medicine and Health Sciences in Washington, DC.

Steven J. Durning

Steven J. Durning, MD, PhD, is a professor and vice chair of the department of medicine and the director of the Center for Health Professions Education at the Uniformed Services University of Health Sciences in Bethesda, MD.